Kristina A Skinner (NPI# 1255744611, PAC ID# 7214155456) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1255744611 |
| PAC ID by PECOS | 7214155456 |
| Professional Enrollment ID | I20140829000254 |
| Full Name | Kristina A Skinner |
| Organization Legal Name | CENTENNIAL MEDICAL GROUP EAST, LLC |
| Address |
145 Ne Broadway St Myrtle Creek OR 97457-9039 |
| Phone Number | 5418633146 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9234397878 |
| Number of Group Practice Members | 37 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380027 | MERCY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 | 5418633146 | CENTENNIAL MEDICAL GROUP EAST, LLC |
| 2510 Nw Medical Park Dr, Roseburg, OR 97471-5510 | 5416777200400 | CENTENNIAL MEDICAL GROUP EAST, LLC |
| 2570 Nw Edenbower Blvd, Suite 100, Roseburg, OR 97471-6214 | 5416777200 | CENTENNIAL MEDICAL GROUP EAST, LLC |
| Organization Legal Name | CENTENNIAL MEDICAL GROUP EAST, LLC |
| Physicians | 35 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brandon W Bonds | Family Medicine | Centennial Medical Group East, LLC | 2510 Nw Medical Park Dr, Roseburg, OR 97471-5510 |
| Stefanie Rae Coffey | Nurse Practitioner | Centennial Medical Group East, LLC | 2570 Nw Edenbower Blvd, Suite 100, Roseburg, OR 97471-6214 |
| Shelley G Brittain | Family Medicine | Centennial Medical Group East, LLC | 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 |
| Mary E Orians | Nurse Practitioner | Centennial Medical Group East, LLC | 2570 Nw Edenbower Blvd, Suite 100, Roseburg, OR 97471-6214 |
| Scott O Goebel | Physician Assistant | Centennial Medical Group East, LLC | 2510 Nw Medical Park Dr, Roseburg, OR 97471-5510 |
| Matthew T Stark | Physician Assistant | Centennial Medical Group East, LLC | 2510 Nw Medical Park Dr, Roseburg, OR 97471-5510 |
| Virginia M Hawes | Internal Medicine | Centennial Medical Group East, LLC | 2510 Nw Medical Park Dr, Roseburg, OR 97471-5510 |
| Nicole Engler | Nurse Practitioner | Centennial Medical Group East, LLC | 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 |
| Charles A Musgrave | Physician Assistant | Centennial Medical Group East, LLC | 2510 Nw Medical Park Dr, Roseburg, OR 97471-5510 |
| Michael F Graham | Physician Assistant | Centennial Medical Group East, LLC | 2570 Nw Edenbower Blvd, Suite 100, Roseburg, OR 97471-6214 |
| Street Address |
145 NE BROADWAY ST |
| City | MYRTLE CREEK |
| State | OR |
| Zip | 97457-9039 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shelley G Brittain | Family Medicine | Centennial Medical Group East, LLC | 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 |
| Nicole Engler | Nurse Practitioner | Centennial Medical Group East, LLC | 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 |
| Timothy J Powell | Family Medicine | Centennial Medical Group East, LLC | 145 Ne Broadway St, Myrtle Creek, OR 97457-9039 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jaime F Serranzana | Family Practice | 925 Nw Pacific Hwy, Myrtle Creek, OR 97457 | |
| Jd Tucker Rohm | Chiropractic | 213 S Old Pacific Hwy, Suite 101, Myrtle Creek, OR 97457-8785 | |
| Lynn Goodwin | Optometry | 425 N Main St, Myrtle Creek, OR 97457-9033 | |
| Sara E Arriero Goff | Nurse Practitioner | Umpqua Community Health Center Inc | 790 S Main St, Myrtle Creek, OR 97457-9303 |
| Paula J Cramer | Nurse Practitioner | Umpqua Community Health Center Inc | 790 S Main St, Myrtle Creek, OR 97457-9303 |
| David D Reneau | Chiropractic | 837 S Main St, Myrtle Creek, OR 97457-9334 | |
| Mark C Phillips | General Practice | 860 N Myrtle Rd, Myrtle Creek, OR 97457-9626 |
| City | MYRTLE CREEK |
| Zip Code | 97457 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MYRTLE CREEK + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kristina A Skinner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.